Weight Loss (Bariatric) Surgery

What is Obesity?

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems.
Overweight and obesity are both labels for ranges of weight that are greater than what is generally considered healthy for a given height.

What is Morbid Obesity?

Obesity becomes “morbid” when there is development of associated medical illness. Morbid obesity is now considered as a chronic disease, meaning that symptoms build slowly over a period of time. Severe obesity is being increasingly recognized as a major health threat.

What is BMI?

Obesity is generally determined by Body Mass Index (BMI). This is determined by a formula for which weight and the height of the person is used.

Below 18.5 Underweight
18.5 – 24.9 Normal
25 – 29.9 Overweight
30 – 34.9 Obese
35 – 39.9 Severe Obesity
> 40 Morbid Obesity
> 50 Super morbid Obesity

As BMI increases the health problems associated with obesity increases and the person is at increased risk compared to the person with normal BMI.

Why surgery is applied to treat obesity?

It has become increasingly clear that those with morbid obesity may not be able to get their weight under significant control on their own without surgery. Even the extensive exercises and diet control is not helpful in significant weight reduction. The surgery as applied to treat obesity because:

  • A significant health risks is associated with morbid obesity.
  • The advancement in the field of laparoscopic surgery has made bariatric surgery a safe and viable option.

Hence surgery should be considered as a last resort but the only effective solution to the big problem.

Are you a candidate for the obesity surgery?

You have to seriously consider the surgical option for reducing weight to avoid its ill effects on your health.

  • If your BMI is over 40
  • If your BMI is 35 or higher and you have a serious medical problem.
  • If you have been unable to reduce weight in spite of serious effort with other non-surgical methods.
  • You have been obese for at least 5 years.
  • Not have depression or other major emotional disorder

Note: Weight reduction surgery is not for all overweight people. It offers an alternative to those who are unable to maintain weight loss through dieting. But it is very important to know that to maintain weight loss after surgery, you still have to eat less food, change the type of food you eat and increase physical activity.

What are different surgical options?

There are various surgical options available that can be offered to the patients for the management of obesity. The commonly performed procedures for weight loss are:

  • Laparoscopic Gastric Banding
  • Sleeve Gastrectomy (Stomach Tube)

Laparoscopic Gastric Banding

The gastric band is a simple silicone ring with an inflatable balloon fitted on its inside. The surgery is done laparoscopically and this band is fastened around the upper part of the stomach.

The application of balloon divides the stomach into a small upper pouch (15ml) and the remainder lower stomach. With the small pouch of the stomach the fullness and satisfaction is experienced with just a small amount of food. The balloon of the band is connected to an injection port by long tubing. This helps in reducing or increasing the size of the passage for the food according to the need of the patient. The reduced food intake results in dramatic weight loss.

The recovery time is rapid. Hospitalization is required only for one night. Many people are able to resume their regular activities a week after their surgery. Since no cutting, stapling or rerouting is required, the operation is considered the least traumatic of all weight loss surgeries.

Gastric Sleeve Surgery

Gastric sleeve surgery is one of the newer types of bariatric (obesity) surgery. This surgery can also be referred to as sleeve gastrectomy, vertical sleeve gastrectomy, tube gastrectomy and laparoscopic sleeve gastrectomy.

During this procedure the surgeon removes about 85 percent of the stomach so that it takes the shape of a tube or sleeve. This operation is performed laparoscopically, meaning that the surgeon makes small incisions as opposed to one large incision. The tube-shaped stomach that is left is sealed closed with staples.

Postoperative treatment and follow up

Aftercare treatments typically include a dietary plan, regular exercise, behavioral-modification therapy, and vitamin supplements. Your surgeon might require the use of a dietician, an exercise program, and possibly a psychologist for an extended period of time to assist you in your recovery.

Plastic surgery after massive weight loss may be necessary to remove excess skin and fat and create a more shapely body profile.

Are abdominoplasty and tummy tuck are bariatric (obesity) surgery procedures?

No, these are post bariatric cosmetic procedures. After massive weight loss after bariatric surgery excessive skin and fat de shape the body. This makes different parts of the body including the abdomen to become pendulous.

Therefore, some of the plastic surgery procedures may become necessary to remove this excessive skin and fatty tissue. These procedures include abdominoplasty, tummy tuck, panniculectomy or body lifts.

However, these cosmetic surgical procedures can be offered to some of the female patients that have their abdomen pendulous after multiple pregnancies or some of the obese patients that are not morbidly obese.

Post bariatric surgery procedures

Panniculectomy, abdominoplasty, tummy tucks or body lift are common post-bariatric procedures.

Additional information